Posts Tagged ‘breast cancer’

Willem Fourie, again…

| May 5th, 2011 | No Comments »

Last week I spent two wonderful days in Vancouver. With hardly any shopping to enhance the experience. I attended an advanced seminar on post-mastectomy care with Willem Fourie, a leader in the world of fascia. Willem is a physiotherapist from South Africa and has made a study of the specific impacts of breast cancer treatment, due to lump- and mast-ectomies, radiation and reconstructions.

I wrote, glowingly, about my introductory course last June. When the opportunity to attend a more advanced course arose I was quick to sign up. Out of the 75 of us who attended last year’s introductory course 11 of us returned this year to broaden our understanding of approaches to care for breast cancer patients.

One of the things that quickly became clear was that we had all, myself included, found uses for the approaches taught by Willem in the 11 month since the first course. We opened the course with each attendee describing how they had employed the techniques and what they sought to learn. Some had very emotional stories to tell of breast cancer patients who they had been able to help and who had inspired them with their strength and courage. Others, myself included, had taken the approaches and been able to apply them with great results to a number of other conditions, from abdominal surgeries to burn victims. The scope of application and success from these fascial techniques was impressive.

The intensity and integrity expressed in the opening of the course set the tone for the whole two days. Often at this type of course there is a very chatty, social atmosphere as the attendees enjoy a break from their regular routines. Schedules are often quick paced and hands on time limited. None of these was the case for this course. There was chatting for certain, but never disruptive to the course. The tone was quiet and the schedule was full of hands on time and quiet diligence. Where hands on time in other courses might become a bit raucous and unfocused in this instance it was very much about applying the techniques and learning to treat what you found in the connective tissue. Though we had no actual breast cancer survivors, we did apply the techniques to the variety of injuries and old surgeries we collectively brought to the occasion. We addressed armpits, abdomens and breasts without giggles or discomfort.

I came away with a deeper understanding of the anatomy, physiology, surgery and the humanity that are all part of treating any patient, most especially those who have faced such monumental challenges as breast cancer. I am continuing diligence of the course having already found several patients who could benefit from these techniques. I hope that they have found some benefit from those two days I spent in thoughtful pursuit of new information and new ideas.

Willem Fourie’s website


My Willem Fourie Course

| June 2nd, 2010 | No Comments »

I was one of a lucky few who got to attend a three day course on treating connective tissue in breast cancer patients taught by Willem Fourie. This course provided me with more specific knowledge and alternate approaches for helping women with breast cancer.

As a Registered Massage Therapist I am required to take a certain number of continuing education hours every two years to maintain my professional standing. A practice I wholeheartedly support and enjoy. When this course was offered, even though I didn’t need all the credits, I leaped at the chance to attend.

Mr. Fourie is a physiotherapist from South Africa and a student of anatomy. He brought an enthusiasm and curiosity to the course that was wonderful. This was not a course full of recipes for treatment, this was a course about understanding. Understanding the structure of the body and what treatment for breast cancer does to that structure. He had brought many dissections that included intact connective tissue, something that is not usual in anatomy books, and ultrasound examinations of post-cancer treatment patients that were enlightening.

This excellent basis was then used to apply our skills in an intelligent, thoughtful way to create better function and ease for our patients. Though I learned few specific techniques in the class, the learning for me was in the specific knowledge about surgery – both tumour removal and reconstruction – that was presented, and the approaches and thought processes used.

Mr. Fourie has a great deal of respect for the human body, and for the human being within that body, which informs all of his approaches. I found his thinking very much in tune with what I try to bring to my work and welcomed the opportunity to work with other professionals in my industry that bring the same thoughtfulness to their work.

Mr. Fourie has participated as a presenter at both the fascial congresses that have happened and taught hundred of practitioners in the UK about his very successful approaches to breast cancer aftercare.

I thoroughly enjoyed this event and am already bringing some of the approaches into my practice – even on non-cancer patients. I look forward to bringing this enrichment of my skill set to more breast cancer patients in future.


Willem Fourie’s website


Massage Therapy as part of Breast Cancer care

| April 12th, 2010 | No Comments »

I have been working with a client who is in recovery from breast cancer and from the effects of the treatment for breast cancer. In many ways the latter is the larger piece. Her body bears the surgical scars of her lumpectomy, the internal effects of chemotherapy and damaged tissue from her radiation therapy.

The portion I have had the opportunity to support is her return to fitness and reducing the impacts of scarring from her lumpectomy and her radiation. Her return to fitness I am supporting by keeping her muscles healthy and in balance and relieving whatever aches, pain and restrictions occur as she begins to return to the vital physical health she had previously.

It is my work with her scars and adhesions is what I wish to focus on though. Any trauma inflicted on the body will cause scarring. In the case of breast cancer treatment you generally have two major traumas inflicted on your chest wall. First, some sort of surgery to remove the cancerous tissue. The second chest wall trauma comes from the radiation. Although no physical invasion occurs, the intense light energy can create burns and always creates an inflammatory response in the body.

These scars can be focal or broad but they, in conjunction with the surgical scars, tend to leave the skin and muscles of the chest wall constricted and tight. The close proximity of the shoulder and the fact that the chest muscles contribute to shoulder movement means that normal movement can be reduced and there can be a pulling pain with any attempt to open up the arm movement.

Now we know the mechanism, lets look at what is done about it. A couple of decades ago the answer would have been nothing, do NOTHING. Fortunately this thinking has fallen by the wayside. Active use of the arm, with such activities as dragon boating, is encouraged. But what happens if you need some help? If, as my client found, the process of simply using the arm is not sufficient to restore the mobility you crave? Or if you restore movement but can not quite relieve the pain the occurs with the extremes of movement? What are your options?

Perhaps the best option is myofascial release. Now, if you have found this, you have found my blog. If you scroll through you will find other pieces dedicated to the wonders of fascia. For those of you interested, I encourage you to read them in full. For now, I will just say that fascia is a form of connective tissue that pervades the body’s structure giving both separation and form. Myofascial release is the practice of releasing restriction in the fascia to restore movement and function to tissue.

Think of a scar as a place where a drop of glue landed and started sticking everything to it. This sticky point continues to adhere things together and in doing so tends to draw the surrounding tissue in tight around it. For some, their determination to move, and/or their own physiology, ensures that they maintain reasonable movement and limited amounts of pain and are able to continue much as they wish in their life. For others we see a progressive advancement of restriction in movement and a concurrent increase in pain with movement. When this is the case some live with that pain their whole live. Myofascial release can change that.

As a Registered Massage Therapist I am one of the best options someone can choose for help. I use my hands to bring tension and stretch into the restrictions and unstick those glued down bits. Over a series of treatments more and more stuck pieces are released, increasing pain-free movement. This encourages more movement, which in turn encourages more release. Then, instead of slowly decreasing movement with increasing pain, we see the opposing trends develop.

Who and when can this intervention help? Though we must wait until the scar has settled, a matter of a few weeks to a couple of months for most, there is no other real limit. Even for those who might be able to self-release these restrictions, a few treatments can hugely speed their recovery. Even if a scar is years old, significant progress can be made to improve function and reduce pain. Though results are often slower with older injuries the impact can still be profound.

Having breast cancer, or any kind of cancer, has a profound impact on your life. There is no way to prevent this impact. Your life will change in ways that you can not predict, or even imagine. What you can impact though, is how you choose to proceed through the course of your illness and, hopefully, recovery. One thing you can choose is getting care for your body that goes beyond treatment for cancer to treating the whole body and ensuring yourself maximal function. Myofascial release can help with the scars of cancer treatment. Generally, Registered Massage Therapy can help relieve pain and improve whole body function.